Five years after its formation, the Clinical and Translational Science Award (CTSA) at the Univeristy of North Carolina at Chapel Hill (UNC), the North Carolina Translational and Clinical Sciences Institute (NC TraCS), has become the integrated, campus-wide home for clinical and translational research at UNC. The overall goal of this U54 Cooperative Agreement application is to combine the research strengths, resources and opportunities at UNC and new partner, RTI International (RTI), to build on the foundation established in the CTSA's last five years. NC TraCS .will work to improve human health by accelerating clinical and translational research from health science discovery to dissemination to patients and communities. NC TraCS will strive to overcome the well-documented barriers to the effective, sustained translation of research discovery along the translational research continuum by improving efficiency, training a research workforce and exporting successful, validated methods developed in NC TraCS to other CTSA institutions and the public. The proposed CTSA will specifically (1) amplify a thriving CTSA program to the point that it supports the full spectrum of clinical and translational research; (2) leverage CTSA resources and institutional strengths to create a critical, sustained focus on three strategic initiatives: (a) next-generation technologies to transform the very nature of clinical research and practice, (b) new paradigms and resources to accelerate drug development, and (c) robust comparative effectiveness research studies to provide definitive evidence of the benefits and harms of tests and treatments; and (3) train, support and incentivize the next generation of clinical and translational science researchers. These goals will be accomplished by three resources, six services, integrated and streamlined from the original 11, and the three strategic initiatives. UNC and RTI now have a unique set of research and training resources to support the full range of clinical and translational research, from basic science to clinical application to policy change. NC TraCS will leverage the opportunity of this CTSA application to garner >$60 million dollars in matching institutional support to extend our capabilities to meet the three aims. In partnership with RTI, NC TraCS will take advantage of the resources it has created and nourished during the past five years to quickly and effectively bring the fruits of research to patients across the state, as well as nationally through the CTSA Consortium.